This application offers to continue and further develop the Twin Tiers CCOP. Building on a successful, proven track record, we propose to involve a team of 26 experienced physician investigators. The Twin Tiers CCOP is a consortium of Lourdes Hospital (grantee organization) and Robert Packer Hospital, who have been working together successfully in the CCOP since its initiation in 1983. Both hospitals had participated in the CGOP prior to the CCOP and both have experienced data management staffs. The specific aims of our program are: a) placing over 70 patients/year on NCI approved clinical research protocols; b) accrue over 50 credits annually on cancer control research protocols; c) continue to involve a team of experienced physician investigators and primary care physicians in the program; d) continue and strengthen our research base relationships; e) continue established mechanisms for quality control; f) continue implementation of our comprehensive data management plan; g) continue mechanisms for the controlled distribution of investigational agents; h) provide a stable administrative structure with significant commitments of personnel, space and local funding; i) further develop the programmatic base of our cancer program that will serve future treatment, cancer control and prevention research initiatives of the NCI. This application provides strong documentation to the regional commitment to NCI research aim and documents a successful track record. We propose to continue with the same organizational structure and expertise which includes a cancer consortium effort between two participating institutions with significant cancer resources and facilities and a multidisciplinary team of experienced oncologic investigators with a protocol accrual record that surpasses NCI standards for CCOPs. Our clinical and cancer control research plan is detailed including: protocol selection procedures, patient log procedures, guidelines for physician participation, job descriptions, patient data flow, patient eligibility, screening and entry procedures; data entry, review, transmission, quality control and feedback; pharmacy and drug management and commitment and support of primary care physicians.